Differential Diagnosis for Loss of Lingual Papillae

• Single Most Likely Diagnosis
  • Geographic tongue: This condition is characterized by the loss of lingual papillae, resulting in patches of smooth, red tissue on the tongue. It is a common and benign condition.
• Other Likely Diagnoses
  • Nutritional deficiencies (e.g., vitamin B12, iron, or zinc deficiency): These deficiencies can cause changes in the tongue's appearance, including the loss of lingual papillae.
  • Oral lichen planus: This chronic inflammatory condition can cause white patches, redness, and loss of papillae on the tongue.
  • Candidiasis: Fungal infections, particularly candidiasis, can lead to the loss of lingual papillae and other oral mucosal changes.
• Do Not Miss Diagnoses
  • Oral cancer: Although less common, oral cancer can cause changes in the tongue's appearance, including the loss of lingual papillae. Early detection is crucial for effective treatment.
  • Pemphigus vulgaris: This autoimmune disorder can cause blistering and erosion of the oral mucosa, leading to the loss of lingual papillae.
• Rare Diagnoses
  • Sjögren's syndrome: This autoimmune disorder can cause dry mouth and other oral changes, including the loss of lingual papillae.
  • Eosinophilic ulcer: A rare condition characterized by the presence of eosinophils in the oral mucosa, which can cause loss of lingual papillae and other oral lesions.
  • Median rhomboid glossitis: A rare condition characterized by a smooth, red, diamond-shaped area on the tongue, often associated with the loss of lingual papillae.